Overview

Research supports the benefits of weight loss surgery for those with a BMI between 35 and 39.9 with obesity related health conditions such as type 2 diabetes, obstructive sleep apnea, high blood pressure, osteoarthritis and other obesity related conditions. You could be a candidate for surgical weight loss if you meet any of the following criteria:

You are more than 100 lbs. over your ideal body weight.

You have a Body Mass Index (BMI) of over 40.

You have a BMI of over 35 and are experiencing severe negative health effects, such as high blood pressure or diabetes, related to being severely overweight.

You are unable to achieve a healthy body weight for a sustained period of time, even through medically-supervised dieting.

FAQs

Why should someone consider having bariatric surgery?

Obesity is harmful to a person’s health. Someone who is 40 percent overweight is twice more likely to die prematurely than an average-weight person. (This effect is seen after 10 to 30 years of being obese.) In this country alone, about 300,000 deaths per year can be blamed on obesity. Obesity is a risk factor for many serious, life-threatening diseases, including:

Studies show that the risk of death from these conditions returns to normal after weight loss. Within the first six months of having weight loss surgery, patients usually no longer need to take medications for these conditions. In addition, women who were struggling with infertility before surgery find that conception is possible after surgery.

Who is eligible for bariatric surgery?

At Cleveland Clinic, we carefully evaluate all patients being considered for bariatric surgery. Nutritional and behavioral counseling are conducted, and patients are required to attend at least one weekly support group session prior to weight loss surgery.

To be eligible for bariatric surgery, you must be between 16 and 70 years of age (with some exceptions) and morbidly obese (weighing at least 100 pounds over your ideal body weight and having a BMI of 40). A BMI between 35 and 39 also may qualify you for the procedure if you also have certain pre-existing co-morbidities, such as diabetes, cardiovascular disease, hypertension, or sleep apnea.

If you are a woman of childbearing age and planning a pregnancy, it’s vital to know that you must not get pregnant within the first 18 months to two years following surgery. The rapid weight loss and nutritional deficiencies associated with bariatric surgery make pregnancy very dangerous for you and for a developing fetus.

A consultation with a Cleveland Clinic bariatric surgeon is a mandatory step prior to surgery, and will help you screen for eligibility.

What bariatric surgical procedures are performed by surgeons at Cleveland Clinic?

Cleveland Clinic offers many surgical options for patients who are interested in bariatric surgery.

The most commonly performed malabsorptive procedure is called the Roux-en-Y gastric bypass. This method makes the stomach smaller and alters digestion. Less food can be eaten and fewer calories can be absorbed. The bariatric surgeon creates a small pouch by dividing the upper end of the stomach. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), as well as the first portion of the jejunum (the second segment of the small intestine). The procedure creates a direct connection from the stomach to the lower segment of the small intestine, literally bypassing portions of the digestive tract that absorb calories and nutrients.

We can also perform the sleeve gastrectomy as a laparoscopic procedure. This involves making five or six small incisions in the abdomen and performing the procedure using a video camera (laparoscope) and long instruments that are placed through these small incisions. During the laparoscopic sleeve gastrectomy (LSG), about 75% of the stomach is removed leaving a narrow gastric “tube” or “sleeve”. No intestines are removed or bypassed during the sleeve gastrectomy. The LSG takes one to two hours to complete. We have an animated video of a sleeve gastrectomy procedure available as well.

In select patients, depending on their situations and needs, Cleveland Clinic bariatric surgeons can perform other surgical options such as gastric plication or duodenal switch.

What is the recovery time following weight loss surgery?

Cleveland Clinic's medical team has an immense wealth of experience in bariatric surgery, this combined with advances in the field of bariatric care, means that most patients recover from surgery quickly and without complications. On average the hospital stay for patients who undergo the Roux-en-Y gastric bypass is usually two to four days. Patients who have the laparoscopic gastric banding procedure typically stay one to two days.

What is my ideal body weight?

Cleveland Clinic's Bariatric and Metabolic Institute follows the guidelines set out by the body mass index scale. This scale recommends a BMI of between 18.5 and 24.9. You can use the calculator above to find your current BMI and ideal BMI.

Is there support from surgeons and staff following weight loss surgery?

Cleveland Clinic's gastric bypass surgery health care team is there to guide patients after each procedure. Regular follow-up visits are scheduled during the first year after weight loss surgery to check overall physical and mental health, metabolism and nutritional status.

How much weight loss can be expected?

Most patients will lose between 66 and 80 percent of their excess body weight, most of which is lost 18 to 24 months following bariatric surgery.

What are the dietary restrictions following weight loss surgery?

Following surgery, you will need to follow specific eating guidelines. Registered dietitians at Cleveland Clinic work directly with bariatric surgery patients to help plan healthful, appropriate meals. Additionally, you will need to stop smoking and discontinue use of NSAIDS.

Is it possible to gain the weight back after surgery?

Bariatric surgery has an excellent long-term track record for helping morbidly obese individuals lose weight. However, there are no guarantees with any method of weight loss, even surgery. Success is possible only if you are committed to making lifestyle and dietary changes for the rest of your life.

What are the risks for bariatric surgery?

All surgical procedures have risks, particularly when the patient is morbidly obese. Different procedures involve different risks, and depending upon your individual circumstances, your risks may be higher or lower than average. It’s also important to know that bariatric surgeons with more experience performing weight loss surgery techniques report fewer complications. Potential risks of surgery should be discussed with your surgeon so you can make an informed choice.

Can bariatric surgery be reversed?

Laparoscopic gastric banding surgery is reversible in a minimally invasive manner. Gastric bypass surgery is potentially reversible. Reversal requires another operation of the same, or greater, magnitude with the same, or greater, risks.

What if I need revision surgery?

Weight loss surgery is not a magic bullet and while most patients are successful after weight loss surgery, there are instances where revision weight loss surgery is required. Whether reasons for seeking revision weight loss surgery are due to inadequate weight loss/weight regain, unresolved co-morbidities and/or medical complications, there is possibly a revision solution to these problems.

Revisional Procedures Overview

Revisional bariatric operations, regardless of the previous surgery, are always challenging for a surgeon. They require adequate expertise to achieve desired results. Bariatric Centers of Excellence certified by the American Society for Bariatric Surgery provide a multi-disciplinary team and facilities for managing patients requiring revision of their surgery. It is highly recommended that patients requiring gastric bypass revision or any other kind of revisional surgery find a surgeon at a bariatric center that has much experience with revisional bariatric surgery.

Will insurance cover bariatric surgery?

Many insurance companies now recognize obesity as a substantial health risk and are paying for bariatric surgery. You can check our list of accepted insurers or contact your insurance provider to find out if gastric bypass surgery (CPT code 43644) is a covered benefit under your insurance contract. If you have other questions, please contact Debra Cash at 216.445.1745 / 800.223.2273, ext. 51745.

What do I need to know about pregnancy after gastric bypass surgery?

During the first 18 months after your gastric bypass surgery, your body is undergoing many changes. Weight loss is a major one, your body is also experiencing hormonal changes, increasing your fertility. Please be cautious during this time and use a method of birth control to insure that you do not become pregnant. If applicable, a pregnancy test will be conducted prior to your surgery.

However, after your surgery, pregnancy is possible if you manage it well with your Cleveland Clinic physician.

Much of the current research suggests that pregnancy in individuals with lower BMI is often safer than pregnancy with complications from obesity. If you have had weight loss surgery and are considering pregnancy, consult your physician safe family planning. It would also be beneficial to mention this to your doctors during the consult for your weight loss surgery so they can provide guidance and resources.

During the first 18 months after your gastric bypass surgery, your body is undergoing many changes, so until your weight and body begin to stabilize, it’s not advisable to become pregnant until 18 months after surgery. Rapid weight loss immediately following surgery creates hormonal changes and might deprive a growing baby of important nutrients.

Why choose Cleveland Clinic?

Cleveland Clinic's Bariatric and Metabolic Institute is widely respected, recognized, and awarded for our revolutionary work in weight loss surgery.

Our board-certified bariatric surgeons meet the highest standard of qualifications and credentialing for bariatric surgery and have performed hundreds of bariatric procedures. Active members of the American Society of Bariatric Surgeons to American Society for Metabolic and Bariatric Surgery, our surgeons emphasize minimally invasive or laparoscopic procedures for 90 percent of bariatric surgeries performed at Cleveland Clinic, thus minimizing complications and speeding recovery.

For the last 15 years, U.S.News & World Report has ranked Cleveland Clinic among the nation’s top hospitals. Cleveland Clinic also is one of only 72 hospitals throughout the entire United States to achieve Magnet status for excellence in nursing services. Cleveland Clinic is accredited by the Joint Commission on Accreditation of Health Care Organizations (JCAHO).

Get Started

If you’re interested in weight loss surgery or medical management, register today for our free online or in-person informational seminar. You’ll learn about what to expect, available options and receive answers to common questions.